Erratic Heart Rate

[csopko]

My girlfriend had a massive heart attack three years ago. For the most part she has recovered very well although she is unable to work and stressful situations seem to give her chest pain.

Thankfully, she is able to exercise 5-6 days a week by walking 3-4 miles at @ 15 minute pace, or by using an elliptical machine for over an hour at a time. She does these things at a reasonable pace and her heart rate seems to hover at around 100 bmp as identified by an exercise heart monitor.

Once a week or so she gets extremely tired and can barely get out of bed. This lethargy has been going on since her heart attack although it has diminished significantly over time. On one such day we put her exercise heart monitor on and it quickly jumped to 120 bmp by simply walking up and down the stairs in our house. A few hours later she tried to go for a walk, but again the monitor jumped to 120-130 soon after we began.

Do you have an idea as to why this might be happening? To me it sounds like she is not getting enough oxygen and her heart has to work overtime to provide her what she needs. It also would explain her lethargy. But I am certainly not sure.  Please know that she has not recently changed her drugs or diet. She has also had numerous EKG's, ECG's and other test that show no problems.  

[Momto3]

You mentioned that your g/f had EKGs and ECGs, but those acronyms can actually refer to the same test.  Just to clarify, has she had a recent echocardiogram, stress test and/or a stress-echo?  The doctor suggested cardiac rehab if deconditioning is at the root of your g/f's problem.  He definitely offered a couple of ideas/suggestions and gave you guys a few places to start.  Once the appropriate tests have ruled out an identifiable problem, your g/f may want to discuss a cardiac rehab with her physician.

I'm sorry if you feel you didn't get the type of answer you were expecting, but if you follow this forum, you know that Dr. MJM is very gracious with his time and consideration.  In fact, he tends to give very individualized responses and often follows up with further responses.

I hope your g/f finds that as time passes, she feels better and better.  Have a great day!

[sugarpea013]

Come on, I understand you are concerned for your girlfriend and are probably desperate for answers...but there is only so much that can be said online. I think we should consider this as more a step in the right direction than definitive health care answers. Good luck to your girlfriend, and I'm sorry you are disappointed in this forum. I am truly thankful for it as well as the support from others.

[csopko]

I must say that I am very disappointed in the answer I recieved from you and your subsequent lack of follow up to my reply.  It appears that once you mark off a question as answered that you simply move on to the next $20 money maker, whether the question was suitaby answered or not.  I'm sure I won't hear back from you which will simply further support my notion that this is nothing other than a quick money making machine.

[jyoti11]

sir ,
my fathers  pulse rate was low and pain in the chest ,but ecg n blood pressure found normal .can u tell me the possible cause .
plz reply me on
***@****

[csopko]

Thanks for your reply, but as I mentioned all of her tests seem to come back normal.  In fact, immediately after her heart attack her ejection fraction was around 40 and it has been rehabilitated to around 60 as of her last test.  

Are there any other things you can think of?  We are at a loss to figure out what is going on.  Thanks!

[Michael J. McWilliams, M.D.]

Do you have an idea as to why this might be happening?

It is hard to tell.  Heart rate usually goes up in response to demand -- the bodies demand for more oxygen.  The part that is hard to figure out is why does it only happen once a week or so, and the other days she is fine.

I would make sure there is a recent stress test and echocardiogram to make sure there are not new blockages or areas not getting enough blood flow.

Cardiac rehab will sometimes help recondition if the issue is deconditioning.

good luck.  thanks for posting.